| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $30.90 | $30.90 | $38.90 | |
Moda Health
| Facility | $13.49 | $25.12 | $58.88 | |
Moda Health
| Professional | $2,041.74 | $2,041.74 | $2,041.74 | |
Providence
| Facility | $13.49 | $25.12 | $58.88 | |
Providence
| Professional | $2,041.74 | $2,041.74 | $2,041.74 |